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Author Notes:

Corresponding Author: Comilla Sasson, MD, MS, Robert Wood Johnson Clinical Scholars Program, 1150 W Medical Center Drive, 6312 Medical Science Building 1, Campus Box 5604, Ann Arbor, MI 48109, 734-647-4844 (office), 734-647-3301 (fax), comilla@umich.edu

Address for reprint requests: Comilla Sasson, MD, MS, Robert Wood Johnson Clinical Scholars Program, 1150 W Medical Center Drive, 6312 Medical Science Building 1, Campus Box 5604, Ann Arbor, MI 48109

Current mailing addresses for all authors: Comilla Sasson, MD, MS. Robert Wood Johnson Clinical Scholars Program, 1150 W Medical Center Drive, 6312 Medical Science Building 1, Campus Box 5604, Ann Arbor, MI 48109 (comilla@umich.edu)Carla C. Keirns, MD, PhD, MS Department of Preventive Medicine, Stony Brook University Medical Center, HSC Level 3, Rm 080, Stony Brook, NY 11794 (carla.keirns@stonybrook.edu) Dylan Smith, PhD, Department of Preventive Medicine, Stony Brook University Medical Center, HSC Level 3, Rm 080, Stony Brook, NY 11794 (Dylan.M.Smith@Stonybrook.edu) Michael Sayre, MD, Department of Emergency Medicine, The Ohio State University, 4821 Cramblett Hall, 456 W. 10th Ave. Columbus, OH 43210 (michael.sayre@ohsumc.edu)Michelle Macy, MD, MS, Department of Emergency Medicine, University of Michigan, A. Alfred Taubman Health Care Center, 1500 East Medical Center Drive, Room B1 380 Ann Arbor, MI 48109-5305 (mlmacy@med.umich.edu)William Meurer, MD, Department of Emergency Medicine, University of Michigan, 1500 East Medical Center Drive, Floor B1, Room B1C255, Ann Arbor, MI 48109-5014 (wmeurer@med.umich.edu)Bryan F. McNally, MD, MPH. Department of Emergency Medicine, Emory University School of Medicine, 531 Asbury Cir - Annex N340, Atlanta, Georgia 30322 (Bryan.McNally@emoryhealthcare.org) Arthur L. Kellermann, MD, MPH, Department of Emergency Medicine, Emory School of Medicine, 1648 Pierce Drive, NE Suite 445, Atlanta, GA 30322 (akell01@emory.edu)Theodore J. Iwashyna, MD, PhD, Division of Pulmonary & Critical Care, Department of Medicine, University of Michigan, North Ingalls Building, 300 North Ingalls, Room 3A23 Ann Arbor, MI 48109-5419 (tiwashyn@umich.edu)

Subject:

Small Area Variations in Out-of-Hospital Cardiac arrest: Does the Neighborhood Matter?

Tools:

Journal Title:

Annals of Internal Medicine

Volume:

Volume 153, Number 1

Publisher:

, Pages 19-22

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background The incidence and outcomes of out-of-hospital cardiac arrest vary widely across cities. It is unknown whether similar differences exist at the neighborhood level. Objective Determine the extent to which different neighborhoods experience persistently high rates of cardiac arrest, but low rates of bystander CPR. Design & Setting Multi-level Poisson regression of 1,018 cardiac arrests from 161 census tracts in Fulton County (Atlanta), Georgia, between October 1, 2005 to November 30, 2008, as captured by the Cardiac Arrest Registry to Enhance Survival (CARES). Measurements Incidence of cardiac arrest by census tract and year and bystander cardiopulmonary resuscitation (CPR) rates. Results Adjusted rates of cardiac arrests varied from across neighborhoods (IQR:0.57–0.73/1000 people; mean 0.64/1000 people, SD 0.10), but were stable from year to year, (ICC=0.36, 95% CI, 0.26–0.50, p value<0.001). Adjusted bystander CPR rates by census tract also varied (IQR: 19–29 percent; mean 0.25, SD 0.10). Limitation Analysis based on data from single city. Conclusion Surveillance data can identify neighborhoods with persistently high incidence of cardiac arrest and low bystander CPR rates. These represent promising targets for community-based interventions.

Copyright information:

© 2014 American College of Physicians. All Rights Reserved.

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